-
Neuroscience and Biobehavioral Reviews Sep 2017The brain-gut-axis is an interdependent system affecting neural functions and controlling our eating behaviour. In recent decades, neuroimaging techniques have... (Review)
Review
The brain-gut-axis is an interdependent system affecting neural functions and controlling our eating behaviour. In recent decades, neuroimaging techniques have facilitated its investigation. We systematically looked into functional and neurochemical brain imaging studies investigating how key molecules such as ghrelin, glucagon-like peptide-1 (GLP-1), peptide tyrosine-tyrosine (PYY), cholecystokinin (CCK), leptin, glucose and insulin influence the function of brain regions regulating appetite and satiety. Of the 349 studies published before July 2016 identified in the database search, 40 were included (27 on healthy and 13 on obese subjects). Our systematic review suggests that the plasma level of ghrelin, the gut hormone promoting appetite, is positively correlated with activation in the pre-frontal cortex (PFC), amygdala and insula and negatively correlated with activation in subcortical areas such as the hypothalamus. In contrast, the plasma levels of glucose, insulin, leptin, PYY, GLP-1 affect the same brain regions conversely. Our study integrates previous investigations of the gut-brain matrix during food-intake and homeostatic regulation and may be of use for future meta-analyses of brain-gut interactions.
Topics: Appetite; Brain; Gastrointestinal Tract; Hormones; Humans; Satiation
PubMed: 28669754
DOI: 10.1016/j.neubiorev.2017.06.013 -
A systematic review on the role of microbiota in the pathogenesis and treatment of eating disorders.European Psychiatry : the Journal of... Dec 2020There is growing interest in new factors contributing to the genesis of eating disorders (EDs). Research recently focused on the study of microbiota. Dysbiosis,...
BACKGROUND
There is growing interest in new factors contributing to the genesis of eating disorders (EDs). Research recently focused on the study of microbiota. Dysbiosis, associated with a specific genetic susceptibility, may contribute to the development of anorexia nervosa (AN), bulimia nervosa, or binge eating disorder, and several putative mechanisms have already been identified. Diet seems to have an impact not only on modification of the gut microbiota, facilitating dysbiosis, but also on its recovery in patients with EDs.
METHODS
This systematic review based on the PICO strategy searching into PubMed, EMBASE, PsychINFO, and Cochrane Library examined the literature on the role of altered microbiota in the pathogenesis and treatment of EDs.
RESULTS
Sixteen studies were included, mostly regarding AN. Alpha diversity and short-chain fatty acid (SCFA) levels were lower in patients with AN, and affective symptoms and ED psychopathology seem related to changes in gut microbiota. Microbiota-derived proteins stimulated the autoimmune system, altering neuroendocrine control of mood and satiety in EDs. Microbial richness increased in AN after weight regain on fecal microbiota transplantation.
CONCLUSIONS
Microbiota homeostasis seems essential for a healthy communication network between gut and brain. Dysbiosis may promote intestinal inflammation, alter gut permeability, and trigger immune reactions in the hunger/satiety regulation center contributing to the pathophysiological development of EDs. A restored microbial balance may be a possible treatment target for EDs. A better and more in-depth characterization of gut microbiota and gut-brain crosstalk is required. Future studies may deepen the therapeutic and preventive role of microbiota in EDs.
Topics: Affect; Anorexia Nervosa; Binge-Eating Disorder; Brain; Bulimia Nervosa; Feeding and Eating Disorders; Gastrointestinal Microbiome; Humans; Psychopathology; Satiety Response
PubMed: 33416044
DOI: 10.1192/j.eurpsy.2020.109 -
The British Journal of Nutrition Feb 2022The aim of this review was to examine: (1) the ability of cholecystokinin (CCK) or analogues of CCK to influence satiation and changes in body weight generally and (2)... (Review)
Review
The aim of this review was to examine: (1) the ability of cholecystokinin (CCK) or analogues of CCK to influence satiation and changes in body weight generally and (2) the efficacy of CCK in influencing satiation and eating behaviour specifically at physiological levels of dosing. A systematic review of the literature was performed following the PRISMA 2020 guidelines in five electronic databases investigating the effect of exogenous CCK or analogues on satiation and body weight. A meta-analysis of studies that infused CCK and measured satiation via changes in food/energy intake was also conducted. A total of 1054 studies were found using the search terms which were reduced to fifteen studies suitable for inclusion. Of the twelve studies measuring the effect on the weight of food ingested or energy intake, eleven showed a decrease. An analogue of CCK which can be administered orally failed to produce any weight loss at 24 weeks. The meta-analysis found the effect of CCK on satiation dosed at physiological levels was significant with a standardised mean difference of 0·57 (95 % CI 0·30, 0·85, < 0·0001). By comparison, CCK dosed at higher, pharmacological levels also had a significant effect with a standardised mean difference of 0·91 (95 % CI 0·46, 1·36, < 0·0001). Eight of the ten studies in the meta-analysis combined CCK infusion with some means to facilitate stomach distension. The present review found evidence that at both physiological and pharmacological levels of dosing CCK has a significant effect on satiation but no evidence for weight loss over the long term.
PubMed: 35152916
DOI: 10.1017/S0007114522000381 -
Maternal & Child Nutrition Apr 2016Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and... (Review)
Review
Responsive feeding has been identified as important in preventing overconsumption by infants. However, this is predicated on an assumption that parents recognise and respond to infant feeding cues. Despite this, relatively little is understood about how infants engage parental feeding responses. Therefore, the aim of this systematic review was to identify what is known about infant communication of hunger and satiation and what issues impact on the expression and perception of these states. A search of Medline, CINAHL, Web of Science, PsycINFO, Science Direct and Maternal and Infant care produced 27 papers. Eligibility criteria included peer reviewed qualitative and/or quantitative publications on feeding behaviours, hunger, and satiation/satiety cues of typically developing children in the first 2 years of life. Papers published between 1966 and 2013 were included in the review. The review revealed that feeding cues and behaviours are shaped by numerous issues, such as infants' physical attributes, individual psychological factors and environmental factors. Meanwhile, infant characteristics, external cues and mothers' own characteristics affect how feeding cues are perceived. The existing literature provides insights into many aspects of hunger and satiation in infancy; however, there are significant gaps in our knowledge. There is a lack of validated tools for measuring hunger and satiation, a need to understand how different infant characteristics impact on feeding behaviour and a need to extricate the respective contributions of infant and maternal characteristics to perceptions of hunger and satiation. Further research is also recommended to differentiate between feeding driven by liking and that driven by hunger.
Topics: Child, Preschool; Communication; Feeding Behavior; Food Preferences; Humans; Hunger; Infant; Infant Behavior; Infant Formula; Infant, Newborn; MEDLINE; Maternal Behavior; Movement; Satiation; Sucking Behavior
PubMed: 26620159
DOI: 10.1111/mcn.12230 -
The Cochrane Database of Systematic... Aug 2016Feeding preterm infants in response to their hunger and satiation cues (responsive, cue-based, or infant-led feeding) rather than at scheduled intervals might enhance... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Feeding preterm infants in response to their hunger and satiation cues (responsive, cue-based, or infant-led feeding) rather than at scheduled intervals might enhance infants' and parents' experience and satisfaction, help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge.
OBJECTIVES
To assess the effect of a policy of feeding preterm infants on a responsive basis versus feeding prescribed volumes at scheduled intervals on growth rates, levels of parent satisfaction, and time to hospital discharge.
SEARCH METHODS
We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 1), MEDLINE via PubMed (1966 to 17 February 2016), Embase (1980 to 17 February 2016), and CINAHL (1982 to 17 February 2016). We also searched clinical trials' databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.
SELECTION CRITERIA
Randomised controlled trials (RCTs) or quasi-RCTs that compared a policy of feeding preterm infants on a responsive basis versus feeding at scheduled intervals.
DATA COLLECTION AND ANALYSIS
Two review authors assessed trial eligibility and risk of bias and undertook data extraction independently. We analysed the treatment effects in the individual trials and reported the risk ratio and risk difference for dichotomous data and mean difference (MD) for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses. We assessed the quality of evidence at the outcome level using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
MAIN RESULTS
We found nine eligible RCTs including 593 infants in total. These trials compared responsive with scheduled interval regimens in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and contained various methodological weaknesses including lack of blinding and incomplete assessment of all randomised participants. Meta-analyses, although limited by data quality and availability, suggest that responsive feeding results in slightly slower rates of weight gain (MD -1.36, 95% CI -2.44 to -0.29 g/kg/day), and provide some evidence that responsive feeding reduces the time taken for infants to transition from enteral tube to oral feeding (MD -5.53, 95% CI -6.80 to -4.25 days). GRADE assessments indicated low quality of evidence. The importance of this finding is uncertain as the trials did not find a strong or consistent effect on the duration of hospitalisation. None of the included trials reported any parent, caregiver, or staff views.
AUTHORS' CONCLUSIONS
Overall, the data do not provide strong or consistent evidence that responsive feeding affects important outcomes for preterm infants or their families. Some (low quality) evidence exists that preterm infants fed in response to feeding and satiation cues achieve full oral feeding earlier than infants fed prescribed volumes at scheduled intervals. This finding should be interpreted cautiously because of methodological weaknesses in the included trials. A large RCT would be needed to confirm this finding and to determine if responsive feeding of preterm infants affects other important outcomes.
Topics: Enteral Nutrition; Humans; Hunger; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Premature; Randomized Controlled Trials as Topic; Satiation; Time Factors; Weight Gain
PubMed: 27580199
DOI: 10.1002/14651858.CD005255.pub5 -
The Cochrane Database of Systematic... Oct 2015Feeding preterm infants in response to their hunger and satiation cues (responsive, cue-based, or infant-led feeding) rather than at scheduled intervals might enhance... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Feeding preterm infants in response to their hunger and satiation cues (responsive, cue-based, or infant-led feeding) rather than at scheduled intervals might enhance infants' and parents' experience and satisfaction, help in the establishment of independent oral feeding, increase nutrient intake and growth rates, and allow earlier hospital discharge.
OBJECTIVES
To assess the effect of feeding preterm infants on a responsive basis versus feeding prescribed volumes at scheduled intervals on growth, duration of hospital stay, and parental satisfaction.
SEARCH METHODS
We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 9, 2015), MEDLINE (1966 to September 2015), EMBASE (1980 to September 2015), and CINAHL (1982 to September 2015), conference proceedings, previous reviews, and trial registries.
SELECTION CRITERIA
Randomised controlled trials (RCTs) or quasi-RCTs that compared a policy of feeding preterm infants on a responsive basis versus feeding at scheduled intervals.
DATA COLLECTION AND ANALYSIS
Two review authors assessed trial eligibility and risk of bias and undertook data extraction independently. We analysed the treatment effects in the individual trials and reported the risk ratio and risk difference for dichotomous data and mean difference (MD) for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses.
MAIN RESULTS
We found nine eligible RCTs including 593 infants in total. These trials compared responsive with scheduled interval regimens in preterm infants in the transition phase from intragastric tube to oral feeding. The trials were generally small and contained various methodological weaknesses including lack of blinding and incomplete assessment of all randomised participants. Meta-analyses, although limited by data quality and availability, suggest that responsive feeding results in slightly slower rates of weight gain (MD -1.4, 95% CI -2.4 to -0.3 g/kg/day), and provide some evidence that responsive feeding reduces the time taken for infants to transition from enteral tube to oral feeding (MD -5.5, 95% CI -6.8 to -4.2 days). The importance of this finding is uncertain as the trials did not find a strong or consistent effect on the duration of hospitalisation. None of the included trials reported any parent, caregiver, or staff views.
AUTHORS' CONCLUSIONS
Overall, the data do not provide strong or consistent evidence that responsive feeding affects important outcomes for preterm infants or their families. Some evidence exists that preterm infants fed in response to feeding and satiation cues achieve full oral feeding earlier than infants fed prescribed volumes at scheduled intervals. However, this finding should be interpreted cautiously because of methodological weaknesses in the included trials. A large RCT would be needed to confirm this finding and to determine if responsive feeding of preterm infants affects other important outcomes.
Topics: Enteral Nutrition; Humans; Hunger; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Premature; Randomized Controlled Trials as Topic; Satiation; Time Factors; Weight Gain
PubMed: 26459238
DOI: 10.1002/14651858.CD005255.pub4 -
European Journal of Clinical Nutrition Mar 2019Humans appear to have innate energy regulation mechanisms that manifest in sensations of satiation during a meal and satiety post ingestion. Interactions between these...
BACKGROUND/OBJECTIVES
Humans appear to have innate energy regulation mechanisms that manifest in sensations of satiation during a meal and satiety post ingestion. Interactions between these mechanisms and the macronutrient profile of their contemporary food environment could be responsible for the dysregulation of this mechanism, resulting in a higher energy intake. The aim of this systematic review was to determine the impact of dietary fibre and fat both in isolation and combination on satiation and satiety.
SUBJECTS/METHODS
A systematic review of the literature was undertaken, from inception until end December 2017, in accordance with the PRISMA guidelines, in: Scopus, Food Science and Tech, CINAHL, and Medline databases. The search strategy was limited to articles in English language, published in peer-reviewed journals and human studies. Studies were selected based on inclusion/exclusion criteria.
RESULTS
A total of 1490 studies were found initially using the selected search terms that were reduced to 12 studies suitable for inclusion. Following on from this, a meta-analysis was also conducted to determine any satiety effects from any potential interaction between dietary fat and fibre on satiety, no significant effects were found.
CONCLUSIONS
Owing to high energy density, fat (per kJ) had a weak effect on satiation as determined by the effect per gram for each unit of energy. The addition of fibre theoretically improves satiety by slowing the absorption of various nutrients including fat, although the meta-analysis as part of this review was unable to demonstrate an effect, perhaps reflecting a lack of sensitivity in research design. The potential to improve satiation and satiety responses by consuming fat together with carbohydrates containing fibre warrants further investigation.
Topics: Dietary Fats; Dietary Fiber; Humans; Satiation; Satiety Response
PubMed: 30166637
DOI: 10.1038/s41430-018-0295-7 -
Nutrients Jan 2022Lupins have a unique nutrient profile among legumes and may have beneficial health effects when included in the diet. The aim of this systematic review was to...
Lupins have a unique nutrient profile among legumes and may have beneficial health effects when included in the diet. The aim of this systematic review was to investigate the effects of lupin on a range of health outcome measures. Databases included MEDLINE, Embase and CINAHL, and focused on controlled intervention studies on healthy adults and those with chronic disease such as type 2 diabetes, cardiovascular disease and overweight. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was followed. Investigated intervention diets utilised whole lupin, lupin protein or lupin fibre, and outcomes were measured by markers of chronic disease, body weight and satiety. Quality assessment of results was performed using the Cochrane revised risk of bias tool. Overall, 21 studies with 998 participants were included: 12 using whole lupin, four used lupin protein and five lupin fibre. Beneficial changes were observed in 71% of studies that measured blood pressure, 83% measuring satiety and 64% measuring serum lipids. Unintended weight loss occurred in 25% of studies. Whole lupin demonstrated more consistent beneficial effects for satiety, glycaemic control and blood pressure than lupin protein or lupin fibre. Heterogeneity, low study numbers and a small participant base indicated further studies are required to strengthen current evidence particularly regarding the protein and dietary fibre components of lupin.
Topics: Body Weight; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Diet; Female; Humans; Lupinus; Male; Overweight; Satiation
PubMed: 35057507
DOI: 10.3390/nu14020327 -
Nutrients Jan 2016Subjective feelings of appetite are measured using visual analogue scales (VAS) in controlled trials. However, the methods used to analyze VAS during the Satiation (pre-... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Subjective feelings of appetite are measured using visual analogue scales (VAS) in controlled trials. However, the methods used to analyze VAS during the Satiation (pre- to post-meal) and Satiety (post-meal to subsequent meal) periods vary broadly, making it difficult to compare results amongst independent studies testing the same product. This review proposes a methodology to analyze VAS during both the Satiation and Satiety periods, allowing us to compare results in a meta-analysis.
METHODS
A methodology to express VAS results as incremental areas under the curve (iAUC) for both the Satiation and Satiety periods is proposed using polydextrose as a case study. Further, a systematic review and meta-analysis on subjective feelings of appetite was conducted following the PRISMA methodology. Meta-analyses were expressed as Standardized Mean Difference (SMD).
RESULTS
Seven studies were included in the meta-analysis. There were important differences in the methods used to analyze appetite ratings amongst these studies. The separate subjective feelings of appetite reported were Hunger, Satisfaction, Fullness, Prospective Food Consumption, and the Desire to Eat. The method proposed here allowed the results of the different studies to be homogenized. The meta-analysis showed that Desire to Eat during the Satiation period favors polydextrose for the reduction of this subjective feeling of appetite (SMD = 0.24, I² < 0.01, p = 0.018); this effect was also significant in the sub-analysis by sex for the male population (SMD = 0.35, I² < 0.01, p = 0.015). There were no other significant results.
CONCLUSION
It is possible to compare VAS results from separate studies. The assessment of iAUC for both the Satiation and Satiety periods generates results of homogeneous magnitudes. This case study demonstrates, for the first time, that polydextrose reduces the Desire to Eat during the Satiation period. This may explain, at least in part, the observed effects of polydextrose on the reduction of levels of energy intake at subsequent meals.
Topics: Adult; Appetite; Area Under Curve; Emotions; Female; Food Additives; Glucans; Humans; Hunger; Male; Middle Aged; Postprandial Period; Randomized Controlled Trials as Topic; Research Design; Satiation; Visual Analog Scale
PubMed: 26784221
DOI: 10.3390/nu8010045 -
Obesity (Silver Spring, Md.) Aug 2014To assess the effect of dietary pulses (beans, peas, chickpeas, lentils) on acute satiety and second meal intake, a systematic review and meta-analysis was conducted. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the effect of dietary pulses (beans, peas, chickpeas, lentils) on acute satiety and second meal intake, a systematic review and meta-analysis was conducted.
METHODS
MEDLINE, EMBASE, CINAHL, and the Cochrane Registry (through May 6, 2013) were searched for acute controlled trials examining the effect of dietary pulses on postprandial satiety or second meal intake compared with isocaloric controls. Two independent reviewers extracted data and assessed methodological quality and risk of bias. Data were pooled by generic inverse variance random effects models and expressed as ratio of means (RoMs) for satiety and mean differences (MDs) for second meal food intake, with 95% confidence intervals (95% CIs). Heterogeneity was assessed (Q statistic) and quantified (I(2) statistic). Protocol registration: clinicaltrials.gov identifier, NCT01605422.
RESULTS
Nine trials met the eligibility criteria. Dietary pulses produced a 31% greater satiety incremental area under the curve (IAUC) (RoM = 1.31, 95% CI: 1.09 to 1.58, P = 0.004; Phet = 0.96; I(2) = 0%) without affecting second meal intake (MD = -19.94, 95% CI: -75-35, P = 0.48; Phet = 0.01; I(2) = 63%). Our data are limited by the small sample sizes, narrow participant characteristics and significant unexplained heterogeneity among the available trials.
CONCLUSIONS
Pooled analyses show that dietary pulses contribute to acute satiety but not second meal intake.
Topics: Diet; Energy Intake; Fabaceae; Humans; Postprandial Period; Randomized Controlled Trials as Topic; Satiation
PubMed: 24820437
DOI: 10.1002/oby.20782